Portuguese Speaking Provider Network Manager

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Job Description:

  • Manages contracting and relations with healthcare providers including but not limited to Hospitals, clinics, pharmacies and physicians.
  • Collaborates with respective teams in performing service area analysis and cost analysis to identify network development and renegotiation opportunities.
  • Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect.
  • Conducts smooth on-boarding and all aspects of health care professional education for existing and newly contracted health care professionals in the region.
  • Manages day-to-day operational maintenance of provider relationships including resolution of potential complaints, escalations, suspensions or threats.
  • Monitors and analyzes data such as Operations KPIs and reconciliation results to provide a comprehensive support to providers on their interpretation.
  • Strive for continuous service improvement via analyses of root causes and proactive implementation of data-driven initiatives.
  • Proactive communication with providers and maintenance of provider communications channels taking into consideration the local habits and practices.
  • Provide consolidated feedback to PSO management team.
  • Conduct provider visits as applicable and regular meetings with your dedicated health care providers.

Requirements:

  • If internal 2 years of Cigna experience, relevant experience in other functions, and a strong performance track record.
  • If external, at least 3 years of experience in provider relations, network management or network operations with a customer/provider-facing experience profile.
  • Proficient in English and Portuguese.
  • Any other additional language is a plus.
  • Strong analytical and problem-solving skills.
  • International mind-set able to work remotely with colleagues, partners and providers across the globe.
  • Striving for excellent service to our members, clients and providers is part of your DNA.
  • Strong can-do attitude, and high qualification in relationship management, including broad understanding of multicultural behaviors.
  • Action-oriented, problem-solving attitude
  • Excellent organization, planning and prioritization skills to meet deadlines.
  • Experience in complaints management - with a proven track record in improving customer service standards.
  • Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome.
  • Accountability – to assume ownership for achieving personal results and to contribute for collective team goals.
  • Excellent communication skills – verbal, written and presentation.
  • Be a positive role model and be able to work independently and in conjunction with co-workers of all levels.
  • Experience interpreting data, drafting reports.
  • Strong practical knowledge of MS Office applications, including Excel.
  • Availability to travel 10% of your time (estimation).

Benefits:

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